影响非肌层浸润性膀胱尿路上皮细胞癌复发相关危险因素

摘要

Objective To study the risk factors and clinical significance of recurrence of non-muscular inva-sive bladder urothelial carcinoma. Methods A total of 90 patients with non-myometrial invasive bladder urothelial car-cinoma, who admitted to our hospital from January 2013 to April 2016, were enrolled in this study. All patients were treated by surgery, and the patient himself or his family were followed up by telephone, letters, visits, outpatient, fol-low-up at bladder irrigation drugs. The main follow-up content were as followes:whether recurrence, recurrence time, whether the regular medication, re-hospitalization situation, and so on. The patients were all followed up for 12 months to a deadline of April 2017. According to the data, the variables of the relevant risk factors were selected and the risk fac-tors and clinical significance of recurrence of non-muscular invasive bladder urothelial carcinoma were analyzed by uni-variate analysis and Cox regression analysis. Results The recurrence rate was 40.0% (36/90) and the average recur-rence-free survival time was 19.73 months. Univariate analysis showed that age, tumor size, tumor staging, grading, post-operative perfusion and previous recurrence of patients were the risk factors associated with tumor recurrence. COX re-gression analysis showed the number of tumors, tumor stage, tumor grade, postoperative perfusion, previous recurrence of patients were tumor recurrence-related risk factors. The effect of patient's gender, tumor diameter, site of existence, and perfusion drug type on tumor recurrence were not significant (P>0.05). Conclusion The risk factors of recurrence of non-muscular invasive bladder urothelial carcinoma are the number of tumors, tumor stage, tumor grade, postopera-tive perfusion and previous recurrence.%目的 研究影响非肌层浸润性膀胱尿路上皮细胞癌复发相关危险因素.方法 回顾性分析2013年1月至2016年4月在本院治疗的非肌层浸润性膀胱尿路上皮癌患者资料共90例,所有患者均经过外科手术治疗,对患者本人或家属通过电话、书信、走访、门诊、膀胱灌注药物同时随访等方式进行随访,主要随访内容有:是否复发、复发时间、是否按时规律用药、再次住院情况等.随访12个月,随访截止时间为2017年4月.根据资料查找,选定相关危险因素的变量,通过单因素分析与Cox回归分析非肌层浸润性膀胱尿路上皮癌的复发相关危险因素与临床意义.结果 90例患者中共36例患者出现术后复发情况,总复发率为40.0%,平均无复发生存时间为19.73个月;单因素中患者年龄、肿瘤数目、肿瘤分期、分级、术后灌注方式与以往复发情况,COX回归多因素分析中显示肿瘤数目、肿瘤分期、肿瘤分级、术后灌注方式、以往复发情况是患者肿瘤复发相关危险因素;而患者性别、肿瘤直径、存在部位、灌注药物种类对肿瘤复发影响效果均不明显(P>0.05).结论 肿瘤数目、肿瘤分期、分级、术后灌注方式与以往复发情况是非肌层浸润性膀胱尿路上皮细胞癌复发的独立危险因素.